Question 1

The telephone triage nurse at a pediatric clinic knows each call is important. Which call would require attentiveness from the nurse because of an increased risk of mortality?

Accepted Answer

A 3-week-old infant born at 35 weeks' gestation with gastroenteritis requires immediate attention due to the increased risk of dehydration and electrolyte imbalance, which can be more severe in preterm infants and potentially lead to increased mortality if not addressed promptly.

Question 2

A child is being prepared for an invasive procedure. The mother of the child has legal custody but is not present. After details of the procedure are explained, who can provide legal consent on behalf of a minor child for treatment?

Accepted Answer

Only a person with written proxy specifically giving them the authority to make medical decisions for the child can provide legal consent on behalf of a minor child for treatment. The other choices do not have legal standing to make medical decisions for the child without proper documentation.

Question 3

Which legal or ethical offense would be committed if a nurse tells family members the condition of a newborn baby without first consulting the parents?

Accepted Answer

Disclosing information about a patient's condition without their consent violates their right to privacy. It is also a breach of confidentiality and may violate HIPAA laws. Therefore, choice A, a breach of privacy, is the most appropriate selection.

Question 4

The nurse in a pediatric acute care unit is assigned the following tasks. Which task is not appropriate for the nurse to complete?

Accepted Answer

It is not within the nurse's scope of practice to diagnose and prescribe medication. This task should be completed by a physician or advanced practice nurse.

Question 5

A nurse is working with pediatric clients in a research facility. The nurse recognizes that federal guidelines are in place that delineate which pediatrics clients must give assent for participation in research trials. Based upon the client's age, the nurse would seek assent from which children? Select all that apply.

Accepted Answer

According to federal guidelines, assent should be obtained from pediatric clients who are capable of understanding the research and its potential risks and benefits. While each child's level of understanding will vary, typically children over the age of 7 or 8 can provide assent. Therefore, the nurse should seek assent from the 7-year-old leukemia client, the 10-year-old with precocious puberty, and the 13-year-old with ADHD. It would not be appropriate to seek assent from the 4-year-old without first evaluating their level of understanding and capacity to provide informed assent.

Question 6

Despite the availability of Children's Health Insurance Programs (CHIP), many eligible children are not enrolled. Which nursing intervention would be the most appropriate to help children become enrolled in CHIP?

Accepted Answer

Advocating for the child by encouraging the family to investigate SCHIP eligibility would be the most appropriate nursing intervention to help children become enrolled in CHIP. This intervention would involve providing information to the family about the availability of CHIP, explaining the eligibility criteria and application process, and offering support and resources to assist the family in completing the enrollment process. This intervention would increase the likelihood that eligible children would be enrolled in CHIP and receive the health care services they need. The other interventions listed may be important but may not address the primary barrier to enrollment, which is lack of awareness or understanding of CHIP eligibility and availability.

Question 7

Which nursing intervention is most appropriate when providing education to the pediatric client and family?

Accepted Answer

When providing education to the pediatric client and their family, it is important to work toward the goal of informed choices with the family. This helps to ensure that the family is actively involved in the child's care and can make informed decisions about their health. The other options are not relevant to providing education to the pediatric client and family.

Question 8

Which nursing role is not directly involved when providing family-centered approach to the pediatric population?

Accepted Answer

While all of the options may be involved in providing a family-centered approach to the pediatric population, the role of a researcher is not a direct involvement in patient care or interaction with families. Research may inform and guide nursing practice, but it does not involve direct engagement with patients and their families.

Question 9

Pediatric nurses have foundational knowledge obtained in nursing school and add specific competencies related to the pediatric client. Which would be considered an additional specific expected competency of the pediatric nurse?

Accepted Answer

Anatomical and developmental differences in pediatric clients require specialized knowledge and assessment skills that are unique to the pediatric population. While physical assessment, nursing process, and management of healthcare conditions are all important competencies for pediatric nurses, they are also basic competencies taught in nursing school and expected of all nurses.

Question 10

What is the pediatric nurse's best defense against an accusation of malpractice or negligence?

Accepted Answer

Meeting the scope and standards of practice for pediatric nursing is the best defense against an accusation of malpractice or negligence. This means following established guidelines and protocols and providing care that is consistent with professional standards.

Question 11

A 12-year-old pediatric client is in need of surgery. Which member of the healthcare team is legally responsible for obtaining informed consent for an invasive procedure?

Accepted Answer

The physician is legally responsible for obtaining informed consent for an invasive procedure, as they are the ones performing the procedure and have the medical knowledge to fully explain the risks and benefits to the patient and their guardian. However, the nurse can assist in the process by ensuring that the patient and their family have all the necessary information and answering any questions they may have.

Question 12

A supervisor is reviewing documentation of the nurses in the unit. Which client documentation is the most accurate and contains all the required part for a narrative entry?

Accepted Answer

Option A includes the date and time of the procedure, brief description of the procedure, amount and appearance of urine, and response of the client during and after the procedure. It also identifies the nurse documenting the entry. This narrative entry contains all the required parts and is accurate. Options B, C, and D are incomplete and lack some required parts of a narrative entry.

Question 13

Which of the following are components of family-centered care? Select all that apply.

Accepted Answer

Family-centered care focuses on recognizing and building on family strengths, meeting the emotional, social, and developmental needs of the child and family, and encouraging parent-to-parent support. It respects diverse family and cultural practices but does not unconditionally support all parenting or cultural practices without consideration of the child's best interests and safety.

Question 14

A 7-year-old child is admitted for acute appendicitis. The parents are questioning the nurse about expectations during the child's recovery. Which information tool would be most useful in answering a parent's questions about the timing of key events?

Accepted Answer

Clinical pathways are specific plans of care that outline key events and expected timings for patients undergoing specific procedures or treatments. In the case of a child with acute appendicitis, a clinical pathway could be used to provide the parents with information on expected recovery time, including when the child may be able to resume normal activities and return to school. The other options, Healthy People 2020, child mortality statistics, and national clinical practice guidelines, are important resources for healthcare professionals but are not as directly applicable to answering a parent's questions about the recovery process for their child.

Question 15

A three-week-old infant is returned post-pyloromyotomy three hours ago. The father is refusing pain medication for the infant and states, "The baby is hungry. Can I give the baby a bottle?" How should the nurse best advocate for the infant? Select all that apply.

Accepted Answer

Educating the parent about the surgery and the need to avoid oral feeding initially is crucial. Informing the parent about the pain scale and the importance of pain management helps advocate for the infant's well-being.

Question 16

The nurse recognizes that the pediatric client is from a cultural background different from that of the hospital staff. Which goal is most appropriate for this client when planning nursing care?

Accepted Answer

It is important to respect and acknowledge the cultural differences of clients in order to provide culturally sensitive care. Goals of nursing care should aim to facilitate compliance with needed care while also being respectful of cultural traditions and beliefs. Option A is not appropriate as it fails to acknowledge the importance of cultural diversity. Option C is also not appropriate as it assumes the nurse's perspective is the only one that matters. Option D may not be appropriate in all circumstances and should only be considered if the cultural practice is safe and does not conflict with medical treatment.

Question 17

A 12-year-old child is admitted to the unit for a surgical procedure. The child is accompanied by two parents and a younger sibling. What is the level of involvement in treatment decision making for this child?

Accepted Answer

The child is not old enough to be considered an emancipated minor or a mature minor, so the parents have the final say in treatment decisions. However, the child should still be included in the decision-making process through the process of assent, where the healthcare team explains the procedure and any potential risks or benefits to the child in a developmentally appropriate way and allows the child to express their preferences or concerns.

Quiz 1: Nurses Role in Care of the Child: Hospital, Community, and Home